The Role of Tumor Deposits in Predicting the Efficacy of Chemotherapy in Stage III Colon Cancer

Shi, Mingyu; Zhang, Hongzhi; Yao, Guozhong; Wu, Jianjun; Zhu, Changtai; Zhang, Xu; Ren, Yuan

doi:10.3389/fonc.2020.586603

Cited by 16 publications

(16 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Substantial evidence has shown that TDs are correlated with increased local recurrence and distant metastasis and impaired DFS and OS (10,11,30). Delattre et al (2) found that postoperative chemotherapy would benefit patients with TDs, which was also validated by Shi et al (31). As one of the most common modalities, postoperative RT also plays an important role in the postoperative management of rectal cancer, especially for those who do not receive preoperative RT.…”

Section: Discussionmentioning

confidence: 92%

Prognostic Nomogram for Rectal Cancer Patients With Tumor Deposits

et al. 2022

View full text Add to dashboard Cite

AimTumor deposits (TDs) are an aggressive hallmark of rectal cancer, but their prognostic value has not been addressed in current staging systems. This study aimed to construct and validate a prognostic nomogram for rectal cancer patients with TDs.MethodsA total of 1,388 stage III–IV rectal cancer patients who underwent radical surgical resection from the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively analyzed to identify the clinical value of TDs. TD-positive rectal cancer patients in the SEER database were used as the training set to construct a prognostic model, which was validated by Fujian Cancer Hospital. Three models were constructed to predict the prognosis of rectal cancer patients with TDs, including the least absolute shrinkage and selection operator regression (LASSO, model 1), backward stepwise regression (BSR, model 2), and LASSO followed by BSR (model 3). A nomogram was established among the three models.ResultsIn the entire cohort, TD was also identified as an independent risk factor for overall survival (OS), even after adjusting for baseline factors, stage, other risk factors, treatments, and all the included variables in this study (all P < 0.05). Among patients with TDs, model 3 exhibited a higher C-index and area under the curves (AUCs) at 3, 4, and 5 years compared with the American Joint Committee on Cancer staging system both in the training and validation sets (all P < 0.05). The nomogram obtained from model 3 showed good consistency based on the calibration curves and excellent clinical applicability by the decision curve analysis curves. In addition, patients were divided into two subgroups with apparently different OS according to the current nomogram (both P < 0.05), and only patients in the high-risk subgroup were found to benefit from postoperative radiotherapy (P < 0.05).ConclusionWe identified a novel nomogram that could not only predict the prognosis of rectal cancer patients with TDs but also provide reliable evidence for clinical decision-making.

show abstract

Section: Discussionmentioning

confidence: 92%

Prognostic Nomogram for Rectal Cancer Patients With Tumor Deposits

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The effect of chemotherapy on CRC patients with TD was inconsistent in previous studies. Shi et al found that the presence of TD and its number did not affect the benefit of chemotherapy in stage III CRC ( 39 ), while Li et al reported that patients with TD did not display a disease-free survival (DFS) benefit from chemotherapy ( 40 ). However, in our study, for the postoperative CRC-NDM patients with TD, chemotherapy (SHR = 0.542, 95% CI: 0.501–0.586) was independently associated with a favorable prognosis.…”

Section: Discussionmentioning

confidence: 99%

Predictive and Prognostic Assessment Models for Tumor Deposit in Colorectal Cancer Patients With No Distant Metastasis

Chen

Zhang

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

BackgroundMore and more evidence indicated that tumor deposit (TD) was significantly associated with local recurrence, distant metastasis (DM), and poor prognosis for patients with colorectal cancer (CRC). This study aims to explore the main clinical risk factors for the presence of TD in CRC patients with no DM (CRC-NDM) and the prognostic factors for TD-positive patients after surgery.MethodsThe data of patients with CRC-NDM between 2010 and 2017 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. A logistic regression model was used to identify risk factors for TD presence. Fine and Gray’s competing-risk model was performed to analyze prognostic factors for TD-positive CRC-NDM patients. A predictive nomogram was constructed using the multivariate logistic regression model. The concordance index (C-index), the area under the receiver operating characteristic (ROC) curve (AUC), and the calibration were used to evaluate the predictive nomogram. Also, a prognostic nomogram was built based on multivariate competing-risk regression. C-index, the calibration, and decision-curve analysis (DCA) were performed to validate the prognostic model.ResultsThe predictive nomogram to predict the presence of TD had a C-index of 0.785 and AUC of 0.787 and 0.782 in the training and validation sets, respectively. From the competing-risk analysis, chemotherapy (subdistribution hazard ratio (SHR) = 0.542, p < 0.001) can significantly reduce CRC-specific death (CCSD). The prognostic nomogram for the outcome prediction in postoperative CRC-NDM patients with TD had a C-index of 0.727. The 5-year survival of CCSD was 17.16%, 36.20%, and 63.19% in low-, medium-, and high-risk subgroups, respectively (Gray’s test, p < 0.001).ConclusionsWe constructed an easily predictive nomogram in identifying the high-risk TD-positive CRC-NDM patients. Besides, a prognostic nomogram was built to help clinicians identify poor-outcome individuals in postoperative CRC-NDM patients with TD. For the high-risk or medium-risk subgroup, additional chemotherapy may be more advantageous for the TD-positive patients rather than radiotherapy.

show abstract

“…The survival benefit of chemotherapy in patients with colorectal cancer with TD has been inconsistent in previous studies because it was not clear whether the pN1c category was or was not equal to LNM ( 9 ). It was reported that the presence and number of TDs did not affect the benefit of chemotherapy in stage III colorectal cancer ( 22 ). It has also been shown that patients with TD did not show a benefit in disease-free survival following chemotherapy ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Value of Adjuvant Chemotherapy in Colon Cancer With Solitary Tumor Deposit

et al. 2022

View full text Add to dashboard Cite

PurposeThe aim of this study is to investigate the survival benefit of adjuvant chemotherapy in patients with colon cancer with the solitary tumor deposit (TD).MethodsThe primary study outcomes used in this study were colon cancer–specific survival (CSS) and overall survival (OS). The differences of the distribution of categorical variables in patients with colon cancer with the solitary TD according to adjuvant chemotherapy administration were tested using the Pearson’s chi-square test. The Kaplan–Meier method was utilized to evaluate CSS and OS. Hazard ratio (HR) and 95% confidence interval (CI) were calculated on the basis of Cox regression models to assess the prognostic value of different demographic and clinicopathological characteristics.ResultsA total of 877 patients with TanyN1cM0 colon cancer with solitary TD were identified in our analysis. It was found that OS (75.4% vs. 42.8% for 5-year OS rate, p < 0.001) and CSS (82.9% vs. 69.3% for 5-year CSS rate, p < 0.001) of patients with colon cancer with adjuvant chemotherapy administration were significantly better than those without adjuvant chemotherapy administration. Multivariate Cox survival analyses revealed that the overall and colon cancer–specific mortality risks of patients with adjuvant chemotherapy administration were decreased by 64.4% (HR = 0.356, 95% CI = 0.265–0.479, p < 0.001) and 57.4% (HR = 0.426, 95% CI = 0.286–0.634, p < 0.001) compared with those without adjuvant chemotherapy administration, respectively.ConclusionsAdjuvant chemotherapy administration could significantly improve OS and CSS in patients with colon cancer with the solitary TD. This is the first study to investigate and demonstrate the survival benefit of adjuvant chemotherapy in patients with colon cancer with the solitary TD.

show abstract

The Role of Tumor Deposits in Predicting the Efficacy of Chemotherapy in Stage III Colon Cancer

Cited by 16 publications

References 24 publications

Prognostic Nomogram for Rectal Cancer Patients With Tumor Deposits

Prognostic Nomogram for Rectal Cancer Patients With Tumor Deposits

Predictive and Prognostic Assessment Models for Tumor Deposit in Colorectal Cancer Patients With No Distant Metastasis

The Prognostic Value of Adjuvant Chemotherapy in Colon Cancer With Solitary Tumor Deposit

Contact Info

Product

Resources

About